title: Value of anticardiolipin antibodies for monitoring disease activity in systemic lupus erythematosus and other rheumatic diseases.
abstract: The prevalence of anticardiolipin antibodies in active systemic lupus erythematosus (SLE) was compared with that in inactive SLE and other rheumatic and non-rheumatic diseases to determine the value of these autoantibodies in monitoring rheumatic diseases. Pairs of IgG- and IgM-aCL were measured by ELISA in 173 consecutive hospitalised patients, including 141 with rheumatic diseases (18 active SLE, 21 inactive SLE, 19 rheumatoid arthritis, 13 reactive arthritis, 7 other spondyloarthropathies, 16 vasculitis, 47 other autoimmune diseases) and 32 non-rheumatic controls. A further 101 aCL pairs were determined during follow-up in 19 patients with SLE. Serum concentrations were analysed with respect to SLE activity and compared between the different patient groups. IgG- and IgM-aCL levels in excess of 10 GPL and 9 MPL respectively were considered positive. 30.6% of all patients (53/173) were found to be positive for IgG-aCL, as against only 9.8% (17/173) for IgM-aCL. IgG-aCL serum levels in active SLE differed significantly from all other groups, including inactive SLE (all p < 0.005). Median IgM-aCL levels were below the cut off point in all groups, although measurable values were obtained almost exclusively in active SLE and RA. In this study IgM-aCL measurement was of less value in monitoring rheumatic diseases. IgG-aCL positivity in SLE was associated with a significantly higher odds ratio (OR) for active disease (OR 16.0, 95% confidence interval: 2.8-90.0). The results show that disease activity in SLE was accompanied by significantly increased IgG-aCL, whereas no elevation was found in other diseases. This parameter may therefore be useful in monitoring SLE activity.
authors.affiliation: Department of Medicine III, Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt-Universität, Berlin, Federal Republic of Germany.
authors.forename: F
authors.initials: F
authors.lastname: Buttgereit
authors.forename: T
authors.initials: T
authors.lastname: Grünewald
authors.forename: W
authors.initials: W
authors.lastname: Schüler-Maué
authors.forename: G R
authors.initials: GR
authors.lastname: Burmester
authors.forename: F
authors.initials: F
authors.lastname: Hiepe
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D003165:Complement System Proteins / Q000032:analysis; D004247:DNA / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012216:Rheumatic Diseases / Q000097:blood*
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D007074:Immunoglobulin G; D003165:Complement System Proteins; D004247:DNA